| NPI | 1659898948 |
|---|---|
| Former Name | SHELBY DIANE GREEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CA 132240) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2023-01-09 |